Manager of Medicare Advantage Coding, Education and Audit - Los Angeles, United States - UCLA Health

UCLA Health Los Angeles, United States

4 weeks ago

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Description

General Information

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Work Location:
Los Angeles, USA

Onsite or Remote

Fully On-Site

Work Schedule

Monday - Friday 8:00am - 5:00pm PST; may require occasional weekends or evening hours

Posted Date

03/04/2024

Salary Range:
$ Annually

Employment Type

Staff: Career

Duration

indefinite

Job #

14520

Primary Duties and Responsibilities

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Note:
Position is onsite with the consideration of flexible hybrid

Take on an important leadership role within an award-winning health system. Help improve patient experiences as part of a world-class healthcare team. Take your career in an exciting new direction. You can do all this and more at UCLA Health.

As a key leader within our Medicare Advantage team, you will develop and execute of strategies, programs, and projects while managing key performance indicators to drive operational excellence.

You will be responsible for leading, developing, and facilitating the team to ensure the application of industry best practices related to accuracy, efficiency, and adherence to all regulatory and CMS compliance requirements.

You will manage the coding consultants who provide audit, coding expertise, and provider education to internal and external clients. You will also serve as a Subject Matter Expert for Medicare Advantage risk adjustment.

Salary offers are determined based on various factors including, but not limited to, qualifications, experience, and equity. The full salary range for this position is $78,800 - $175,000 Annually.

The budgeted salary range that the University reasonably expects to pay for this position is about $115,000 - $140,000 Annually.

Job Qualifications

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We're seeking a self-motivated, flexible, goal-driven, service-oriented leader with:

This role will require occasional travel to local provider offices
Required Certified Professional Coder (CPC-I) certification, Certified Risk Adjustment (CRC) coder AAPC certification, and Certified Professional Medical Auditor (CPMA) certifications from AAPC (to obtain CPMA within 120 days from date of hire, if applicant does not currently possess)
Six or more years of risk adjustment experience
Three to five years of provider education experience with the development of educational materials and presentations
Five or more years of physician billing/coding experience
Previous managerial experience
Exceptional relationship-building skills with clinical and non-clinical personnel
Knowledge of the Medicare Advantage STARS program and NCQA technical specifications
In-depth understanding of HIPAA
Extensive knowledge of HCC models V24 and V28
Familiarity with claims and encounter data processes
Experience conducting mock RADV or actual RADV
Related Bachelor's degree and RN licensure preferred
Strong leadership, communication, prioritizing, and interpersonal skills
Ability to develop, implement, and evaluate methods and systems to improve efficiency
Expertise in leading cross-functional workgroups

UCLA Health is a world-renowned health system with four award-winning hospitals and more than 260 community clinics throughout Southern California.

We're also home to the world-class medical research and clinical education capabilities of the David Geffen School of Medicine. Through the efforts of our outstanding people, we have become Los Angeles' trusted provider of exceptional, compassionate patient care. If you're looking to experience greater challenge and fulfillment in your career, you can at UCLA Health.

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